How much rates vary
Facilitymedian $4,365 · 10th to 90th $468 to $12,303Professionalmedian $5,248 · 10th to 90th $3,981 to $8,128
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $2,238.72 Median $5,011.87 Typical High $10,715.19 | Facility | None | $2,238.72 | $5,011.87 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $5,495.41 | Professional | None | $5,248.07 | $5,248.07 | $5,495.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,495.41 Median $9,772.37 Typical High $12,302.69 | Facility | None | $5,495.41 | $9,772.37 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $4,677.35 Median $5,754.40 Typical High $10,471.29 | Professional | None | $4,677.35 | $5,754.40 | $10,471.29 |
Hometown Health Setting Professional Modifier None Typical Low $45.71 Median $5,011.87 Typical High $7,413.10 | Professional | None | $45.71 | $5,011.87 | $7,413.10 |
Hometown Health Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $6,606.93 | Professional | None | $38.90 | $38.90 | $6,606.93 |
Select Health Setting Facility Modifier None Typical Low $4,265.80 Median $4,365.16 Typical High $4,365.16 | Facility | None | $4,265.80 | $4,365.16 | $4,365.16 |
Select Health Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,981.07 | $3,981.07 | $3,981.07 |
United Setting Facility Modifier None Typical Low $302.00 Median $794.33 Typical High $2,951.21 | Facility | None | $302.00 | $794.33 | $2,951.21 |
United Setting Professional Modifier None Typical Low $3,235.94 Median $4,897.79 Typical High $7,585.78 | Professional | None | $3,235.94 | $4,897.79 | $7,585.78 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2,570.40 Median $2,570.40 Typical High $2,754.23 | Professional | 52 · Reduced service | $2,570.40 | $2,570.40 | $2,754.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,047.13 Median $1,047.13 Typical High $1,096.48 | Professional | 53 · Discontinued | $1,047.13 | $1,047.13 | $1,096.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,890.45 Median $3,890.45 Typical High $4,073.80 | Professional | 54 · Surgery only | $3,890.45 | $3,890.45 | $4,073.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $776.25 Median $776.25 Typical High $812.83 | Professional | 55 · Aftercare only | $776.25 | $776.25 | $812.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $524.81 Median $524.81 Typical High $549.54 | Professional | 56 · Pre-op care only | $524.81 | $524.81 | $549.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,630.78 Median $3,630.78 Typical High $3,801.89 | Professional | 78 · Unplanned return to OR | $3,630.78 | $3,630.78 | $3,801.89 |
Where Nevada sits
The same service costs 8.4 times more in Wisconsin than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
WI $28,671TX $3,407
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.